AIM: To clarify the relationship between the change of serum amylase level and post-ERCP pancreatitis. METHODS: Between January 1999 and December 2002, 1291 ERCP-related procedures were performed. Serum amylase concen...AIM: To clarify the relationship between the change of serum amylase level and post-ERCP pancreatitis. METHODS: Between January 1999 and December 2002, 1291 ERCP-related procedures were performed. Serum amylase concentrations were measured before the procedure and 3, 6, and 24 h afterward. The frequency and severity of post-ERCP pancreatitis and the relationship between these phenomena and the change in amylase level were estimated. RESULTS: Post-ERCP pancreatitis occurred in 47 patients (3.6%). Pancreatitis occurred in 1% of patients with normal amylase levels 3 h after ERCP, and in 1%, 5%, 20%, 31% and 39% of patients with amylase levels elevated 1-2 times, 2-3 times, 3-5 times, 5-10 times and over 10 times the upper normal limit at 3 h after ERCP, respectively (level < 2 times vs ≥ 2 times, P < 0.001). Of the 143 patients with levels higher than the normal limit at 3 h after ERCP followed by elevation at 6 h, pancreatitis occurred in 26%. In contrast, pancreatitis occurred in 9% of 45 patients with a level higher than two times the normal limit at 3 h after ERCP followed by a decrease at 6 h (26% vs 9%, P < 0.05). CONCLUSION: Post-ERCP pancreatitis is frequently associated with an increase in serum amylase level greater than twice the normal limit at 3 h after ERCP with an elevation at 6 h. A decrease in amylase level at 6 h after ERCP suggests the unlikelihood of development of post-ERCP pancreatitis.展开更多
For the last decade, low serum amylase(hypoamylasemia) has been reported in certain common cardiometabolic conditions such as obesity, diabetes(regardless of type), and metabolic syndrome, all of which appear to have ...For the last decade, low serum amylase(hypoamylasemia) has been reported in certain common cardiometabolic conditions such as obesity, diabetes(regardless of type), and metabolic syndrome, all of which appear to have a common etiology of insufficient insulin action due to insulin resistance and/or diminished insulin secretion. Some clinical studies have shown that salivary amylase may be preferentially decreased in obese individuals, whereas others have revealed that pancreatic amylase may be preferentially decreased in diabetic subjects with insulin dependence. Despite this accumulated evidence, the clinical relevance of serum, salivary, and pancreatic amylase and the underlying mechanisms have not been fully elucidated. In recent years, copy number variations(CNVs) in the salivary amylase gene(AMY1), which range more broadly than the pancreatic amylase gene(AMY2A and AMY2B), have been shown to be well correlated with salivary and serum amylase levels. In addition, low CNV of AMY1, indicating low salivary amylase, was associated with insulin resistance, obesity, low taste perception/satiety, and postprandial hyperglycemia through impaired insulin secretion at early cephalic phase. In most populations, insulin-dependent diabetes is less prevalent(minor contribution) compared with insulin-independent diabetes, and obesity is highly prevalent compared with low body weight. Therefore, obesity as a condition that elicits cardiometabolic diseases relating to insulin resistance(major contribution) may be a common determinant for low serum amylase in a general population. In this review, the novel interpretation of low serum, salivary, and pancreas amylase is discussed in terms of major contributions of obesity, diabetes, and metabolic syndrome.展开更多
<strong>Background:</strong> Geophagy is the consumption of earth materials which occurs across several cultures. For several reasons, pregnant women in many parts of West Africa including Nigeria frequent...<strong>Background:</strong> Geophagy is the consumption of earth materials which occurs across several cultures. For several reasons, pregnant women in many parts of West Africa including Nigeria frequently consume kaolin. This study was carried out to determine the influence of kaolin consumption on serum electrolytes, glucose and amylase levels of pregnant women attending antenatal clinic in a Teaching Hospital in the south east Nigeria. <strong>Methods: </strong>A total of eighty pregnant women recruited for this study were grouped as follows;Group 1, (30 geophagic pregnant women in the first trimester), Group 2 (30 geophagic pregnant women in the second trimester) and Group 3 (20 non-geophagic pregnant women that served as control). Subjects in Groups 1 and 2 were subdivided into three based on the quantity of kaolin consumed per week: group A (100 g/week), group B (150 g/week) and group C (200 g/week). Preliminary analysis of the calcium content of kaolin was carried out. Serum levels of potassium, sodium, chloride, bicarbonate, glucose and amylase of the subjects were determined. <strong>Results:</strong> Calcium level in kaolin was below the recommended daily intake in food. The concentrations of potassium in geophagic pregnant women who consumed 150 g and 200 g of kaolin per week were significantly (p < 0.05) lower in both 1<sup>st</sup> and 2<sup>nd</sup> trimester groups., There was a significant (p < 0.05) decrease in sodium concentration (132.2 ± 2.0) of the 2<sup>nd</sup> trimester pregnant women that consumed 200 g of kaolin per week. The concentrations of chloride and bicarbonate were not significantly (p > 0.05) affected in all the groups. Serum amylase concentration decreased significantly (p < 0.05) in the 1<sup>st</sup> and 2<sup>nd</sup> trimester pregnant women on 150 g and 200 g of kaolin per week, while the plasma glucose concentration was significantly (p < 0.05) elevated in the same groups. <strong>Conclusion:</strong> This study concludes that kaolin consumption in pregnant women may predispose to gestational diabetes, electrolytes imbalance and reduced intestinal enzymes activities.展开更多
目的探讨血清淀粉酶(serum amylase,AMS)、肌酸激酶(creatine kinase,CK)联合血清炎症因子检测对2型糖尿病酮症酸中毒继发感染的诊断价值。方法选取2021年1月—2022年12月晋江市医院晋南分院接诊收治的120例2型糖尿病酮症酸中毒患者作...目的探讨血清淀粉酶(serum amylase,AMS)、肌酸激酶(creatine kinase,CK)联合血清炎症因子检测对2型糖尿病酮症酸中毒继发感染的诊断价值。方法选取2021年1月—2022年12月晋江市医院晋南分院接诊收治的120例2型糖尿病酮症酸中毒患者作为研究对象。根据患者病原学检查是否继发感染分为对照组和观察组,对照组60例患者均无感染,观察组60例患者继发感染。比较2组患者AMS、CK及相关血清炎症因子水平,分析风险因素并绘制单一指标、联合指标检测受试者工作特征(receiver operating characteristic,ROC)曲线。结果观察组患者AMS、CK、降钙素原(procalcitonin,PCT)和白介素-6(interleukin-6,IL-6)水平均高于对照组(P<0.05)。多元logistic回归显示,AMS、CK、PCT均为2型糖尿病酮症酸中毒患者发生感染的危险因素(P<0.05)。同时ROC曲线显示,AMS、CK、PCT、IL-6及联合检测的曲线下面积(area under the curve,AUC)分别为0.825、0.884、0.919、0.836、0.965。联合检测准确性高于单一指标检测水平(P<0.05)。结论AMS、CK、PCT及IL-6水平在2型糖尿病酮症酸中毒感染患者中升高,且4项指标联合检测对提升2型糖尿病酮症酸中毒继发感染早期诊断的敏感度和准确性具有积极意义。展开更多
目的:分析血清淀粉酶(Amylase,AMY)、同型半胱氨酸(Homocysteine,Hcy)、D-二聚体(D-dimer,D-D)水平及联合检测对急性胰腺炎(Acutepancreatitis,AP)患者预后的预测价值。方法:选取2020年5月-2023年6月期间本院收治的AP患者为研究对象。...目的:分析血清淀粉酶(Amylase,AMY)、同型半胱氨酸(Homocysteine,Hcy)、D-二聚体(D-dimer,D-D)水平及联合检测对急性胰腺炎(Acutepancreatitis,AP)患者预后的预测价值。方法:选取2020年5月-2023年6月期间本院收治的AP患者为研究对象。根据患者治疗后的预后情况,将患者分为预后良好组(43例)及预后不良组(19例)。收集并对比两组的一般资料及血清AMY、Hcy、D-D水平。logistic回归模型分析影响AP患者预后的影响因素。分析血清各指标水平联合检测对AP预后的预测效能。结果:预后不良组入院时急性生理功能和慢性健康状况评分系统Ⅱ(Acute physiological function and Chronic health status score SystemⅡscore,APACHEⅡ)评分及血清Hcy、AMY、D-D水平均显著高于预后良好组(P<0.05)。Logistic回归分析显示,入院时血清Hcy、AMY、D-D及APACHEⅡ评分均为患者发生预后不良的危险因素(P<0.05)。入院时AMY、Hcy、D-D水平联合预测患者发生预后不良的曲线下面积(AUC)为0.879。结论:血清AMY、Hcy、D-D水平与AP患者预后密切相关,三者联合检测在患者预后评估中具有重要价值。展开更多
AIM To estimate the efficacy of 2 h post-endoscopic retrograde cholangiopancreatography(ERCP) serum amylase levels and other factors for predicting postERCP pancreatitis.METHODS This was a retrospective,single-center ...AIM To estimate the efficacy of 2 h post-endoscopic retrograde cholangiopancreatography(ERCP) serum amylase levels and other factors for predicting postERCP pancreatitis.METHODS This was a retrospective,single-center cohort study of consecutive patients who underwent ERCP from January 2010 to December 2013.Serum amylase levels were measured 2 h post-procedure,and patient- and procedure-related pancreatitis(PEP) risk factors wereanalyzed using a logistic model.RESULTS A total of 1520 cases(average age 72 ± 12 years,60% male) were initially enrolled in this study,and 1403 cases(725 patients) were ultimately analyzed after the exclusion of 117 cases.Fifty-five of these cases developed PEP.We established a 2 h serum amylase cutoff level of two times the upper limit of normal for predicting PEP.Multivariate analysis revealed that a cannulation time of more than 13 min [odds ratio(OR) 2.28,95%CI:1.132-4.651,P=0.0210] and 2 h amylase levels greater than the cutoff level(OR=24.1,95%CI:11.56-57.13,P<0.0001) were significant predictive factors for PEP.Forty-seven of the 55 patients who developed PEP exhibited 2 h amylase levels greater than the cutoff level(85%),and six of the remaining eight patients who developed PEP(75%) required longer cannulation times.Only 2 of the 1403 patients(0.14%) who developed PEP did not exhibit concerning 2 h amylase levels or require longer cannulation times.CONCLUSION These findings indicate that the combination of 2 h post-ERCP serum amylase levels and cannulation times represents a valuable marker for identifying patients at high risk for PEP.展开更多
文摘AIM: To clarify the relationship between the change of serum amylase level and post-ERCP pancreatitis. METHODS: Between January 1999 and December 2002, 1291 ERCP-related procedures were performed. Serum amylase concentrations were measured before the procedure and 3, 6, and 24 h afterward. The frequency and severity of post-ERCP pancreatitis and the relationship between these phenomena and the change in amylase level were estimated. RESULTS: Post-ERCP pancreatitis occurred in 47 patients (3.6%). Pancreatitis occurred in 1% of patients with normal amylase levels 3 h after ERCP, and in 1%, 5%, 20%, 31% and 39% of patients with amylase levels elevated 1-2 times, 2-3 times, 3-5 times, 5-10 times and over 10 times the upper normal limit at 3 h after ERCP, respectively (level < 2 times vs ≥ 2 times, P < 0.001). Of the 143 patients with levels higher than the normal limit at 3 h after ERCP followed by elevation at 6 h, pancreatitis occurred in 26%. In contrast, pancreatitis occurred in 9% of 45 patients with a level higher than two times the normal limit at 3 h after ERCP followed by a decrease at 6 h (26% vs 9%, P < 0.05). CONCLUSION: Post-ERCP pancreatitis is frequently associated with an increase in serum amylase level greater than twice the normal limit at 3 h after ERCP with an elevation at 6 h. A decrease in amylase level at 6 h after ERCP suggests the unlikelihood of development of post-ERCP pancreatitis.
文摘For the last decade, low serum amylase(hypoamylasemia) has been reported in certain common cardiometabolic conditions such as obesity, diabetes(regardless of type), and metabolic syndrome, all of which appear to have a common etiology of insufficient insulin action due to insulin resistance and/or diminished insulin secretion. Some clinical studies have shown that salivary amylase may be preferentially decreased in obese individuals, whereas others have revealed that pancreatic amylase may be preferentially decreased in diabetic subjects with insulin dependence. Despite this accumulated evidence, the clinical relevance of serum, salivary, and pancreatic amylase and the underlying mechanisms have not been fully elucidated. In recent years, copy number variations(CNVs) in the salivary amylase gene(AMY1), which range more broadly than the pancreatic amylase gene(AMY2A and AMY2B), have been shown to be well correlated with salivary and serum amylase levels. In addition, low CNV of AMY1, indicating low salivary amylase, was associated with insulin resistance, obesity, low taste perception/satiety, and postprandial hyperglycemia through impaired insulin secretion at early cephalic phase. In most populations, insulin-dependent diabetes is less prevalent(minor contribution) compared with insulin-independent diabetes, and obesity is highly prevalent compared with low body weight. Therefore, obesity as a condition that elicits cardiometabolic diseases relating to insulin resistance(major contribution) may be a common determinant for low serum amylase in a general population. In this review, the novel interpretation of low serum, salivary, and pancreas amylase is discussed in terms of major contributions of obesity, diabetes, and metabolic syndrome.
文摘<strong>Background:</strong> Geophagy is the consumption of earth materials which occurs across several cultures. For several reasons, pregnant women in many parts of West Africa including Nigeria frequently consume kaolin. This study was carried out to determine the influence of kaolin consumption on serum electrolytes, glucose and amylase levels of pregnant women attending antenatal clinic in a Teaching Hospital in the south east Nigeria. <strong>Methods: </strong>A total of eighty pregnant women recruited for this study were grouped as follows;Group 1, (30 geophagic pregnant women in the first trimester), Group 2 (30 geophagic pregnant women in the second trimester) and Group 3 (20 non-geophagic pregnant women that served as control). Subjects in Groups 1 and 2 were subdivided into three based on the quantity of kaolin consumed per week: group A (100 g/week), group B (150 g/week) and group C (200 g/week). Preliminary analysis of the calcium content of kaolin was carried out. Serum levels of potassium, sodium, chloride, bicarbonate, glucose and amylase of the subjects were determined. <strong>Results:</strong> Calcium level in kaolin was below the recommended daily intake in food. The concentrations of potassium in geophagic pregnant women who consumed 150 g and 200 g of kaolin per week were significantly (p < 0.05) lower in both 1<sup>st</sup> and 2<sup>nd</sup> trimester groups., There was a significant (p < 0.05) decrease in sodium concentration (132.2 ± 2.0) of the 2<sup>nd</sup> trimester pregnant women that consumed 200 g of kaolin per week. The concentrations of chloride and bicarbonate were not significantly (p > 0.05) affected in all the groups. Serum amylase concentration decreased significantly (p < 0.05) in the 1<sup>st</sup> and 2<sup>nd</sup> trimester pregnant women on 150 g and 200 g of kaolin per week, while the plasma glucose concentration was significantly (p < 0.05) elevated in the same groups. <strong>Conclusion:</strong> This study concludes that kaolin consumption in pregnant women may predispose to gestational diabetes, electrolytes imbalance and reduced intestinal enzymes activities.
文摘目的探讨血清淀粉酶(serum amylase,AMS)、肌酸激酶(creatine kinase,CK)联合血清炎症因子检测对2型糖尿病酮症酸中毒继发感染的诊断价值。方法选取2021年1月—2022年12月晋江市医院晋南分院接诊收治的120例2型糖尿病酮症酸中毒患者作为研究对象。根据患者病原学检查是否继发感染分为对照组和观察组,对照组60例患者均无感染,观察组60例患者继发感染。比较2组患者AMS、CK及相关血清炎症因子水平,分析风险因素并绘制单一指标、联合指标检测受试者工作特征(receiver operating characteristic,ROC)曲线。结果观察组患者AMS、CK、降钙素原(procalcitonin,PCT)和白介素-6(interleukin-6,IL-6)水平均高于对照组(P<0.05)。多元logistic回归显示,AMS、CK、PCT均为2型糖尿病酮症酸中毒患者发生感染的危险因素(P<0.05)。同时ROC曲线显示,AMS、CK、PCT、IL-6及联合检测的曲线下面积(area under the curve,AUC)分别为0.825、0.884、0.919、0.836、0.965。联合检测准确性高于单一指标检测水平(P<0.05)。结论AMS、CK、PCT及IL-6水平在2型糖尿病酮症酸中毒感染患者中升高,且4项指标联合检测对提升2型糖尿病酮症酸中毒继发感染早期诊断的敏感度和准确性具有积极意义。
文摘目的:分析血清淀粉酶(Amylase,AMY)、同型半胱氨酸(Homocysteine,Hcy)、D-二聚体(D-dimer,D-D)水平及联合检测对急性胰腺炎(Acutepancreatitis,AP)患者预后的预测价值。方法:选取2020年5月-2023年6月期间本院收治的AP患者为研究对象。根据患者治疗后的预后情况,将患者分为预后良好组(43例)及预后不良组(19例)。收集并对比两组的一般资料及血清AMY、Hcy、D-D水平。logistic回归模型分析影响AP患者预后的影响因素。分析血清各指标水平联合检测对AP预后的预测效能。结果:预后不良组入院时急性生理功能和慢性健康状况评分系统Ⅱ(Acute physiological function and Chronic health status score SystemⅡscore,APACHEⅡ)评分及血清Hcy、AMY、D-D水平均显著高于预后良好组(P<0.05)。Logistic回归分析显示,入院时血清Hcy、AMY、D-D及APACHEⅡ评分均为患者发生预后不良的危险因素(P<0.05)。入院时AMY、Hcy、D-D水平联合预测患者发生预后不良的曲线下面积(AUC)为0.879。结论:血清AMY、Hcy、D-D水平与AP患者预后密切相关,三者联合检测在患者预后评估中具有重要价值。
文摘AIM To estimate the efficacy of 2 h post-endoscopic retrograde cholangiopancreatography(ERCP) serum amylase levels and other factors for predicting postERCP pancreatitis.METHODS This was a retrospective,single-center cohort study of consecutive patients who underwent ERCP from January 2010 to December 2013.Serum amylase levels were measured 2 h post-procedure,and patient- and procedure-related pancreatitis(PEP) risk factors wereanalyzed using a logistic model.RESULTS A total of 1520 cases(average age 72 ± 12 years,60% male) were initially enrolled in this study,and 1403 cases(725 patients) were ultimately analyzed after the exclusion of 117 cases.Fifty-five of these cases developed PEP.We established a 2 h serum amylase cutoff level of two times the upper limit of normal for predicting PEP.Multivariate analysis revealed that a cannulation time of more than 13 min [odds ratio(OR) 2.28,95%CI:1.132-4.651,P=0.0210] and 2 h amylase levels greater than the cutoff level(OR=24.1,95%CI:11.56-57.13,P<0.0001) were significant predictive factors for PEP.Forty-seven of the 55 patients who developed PEP exhibited 2 h amylase levels greater than the cutoff level(85%),and six of the remaining eight patients who developed PEP(75%) required longer cannulation times.Only 2 of the 1403 patients(0.14%) who developed PEP did not exhibit concerning 2 h amylase levels or require longer cannulation times.CONCLUSION These findings indicate that the combination of 2 h post-ERCP serum amylase levels and cannulation times represents a valuable marker for identifying patients at high risk for PEP.
